Intravenous colistin in the treatment of multidrug-resistant gram-negative organism in tertiary hospital, Jazan, KSA

BACKGROUND: It was considered that the resistance of drugs such as carbapenems and cephalosporins against severe or high risk gram-negative bacteria became a tremendous confront. This might be attributed to the little amount of these drugs to be used against the multi-resistant bacteria (MRB). Therefore, Colistin, Fosfomycin, Temocillin, and Rifampicin are antibiotics that have been used as multidrug-resistant bacterial infections in the treatment of some species of bacteria such as Acinetobacter, Pseudomonas species, and Enterobacteriaceae. AIM: the present study is aimed to assess the integrity and efficiency of colistin for treating of the multidrug-resistant bacteria (MDR) especially gram-negative one among critical and non-critical patients in tertiary hospital in Jazan city. Ninety four patients who met the selection criteria and received colistimethate sodium (colistin) in the period between Februarys 2017 and March 2018 were recruited and their charts were reviewed retrospectively. Patients' information, medical conditions, and laboratory data were extracted. All patients received IV colistin, and the majority of the patients showed in their culture reports multidrug-resistant bacteria such as Pseudomonas aeruginosa and Acinetobacter baumannii. Patients who had normal renal function received from 2.5 to 5.0 mg of colistin/kg, which was divided in two or three doses intravenously, for duration ranging between 10 and 14 days. RESULTS AND CONCLUSION: Approximately half of patients (48.93%) were fully recovered, while 19% of them were partially responded to colistin treatment. In the current study it was showed that IV colistin treatment against the multidrug-resistant bacteria (gram-negative bacteria) was strongly related to mild nephrotoxicity in addition to with a proper response as shown only in three of our patients